Workplace insurers spend an estimated $1.4 billion annually on opioid pain medication for injured workers, and this number has continued to rise over the past decade. A recent article in the New York Times, Painkillers Add Costs and Delays to Workplace Injuries highlights a 2008 study by the California Workers Compensation Institute that found that workers who received high doses of opioids stayed out of work three times longer compared with workers with similar injuries who received lower doses of opioids. However, one must not look at these data in isolation and out of context of current health care reimbursement practices — is it the dose of opioids or other factors that contributed to their inability to return to work? A trend over the past decade has been for insurers to reimburse for prescription medication but to reduce or eliminate reimbursement for other pain therapies such as physical therapy, behavioral therapy and intergrative models of pain management. Perhaps examining current best practices for pain management, which include pharmaceutical as well as other non-pharmaceutical therapies will result in more positive outcomes for injured workers and cost savings for workplace insurers.

Discussion about international collaboration between Xiaoshu Zhu (University of Western Sydney, Australia), Ewan McNichol (PREP program faculty, TUSM) and MS-PREP program graduate and acupuncturist, Kindreth Hamilton